Trauma Certified Registered Nurse (TCRN) Practice Exam

Which intervention is contraindicated for a patient with a high riding prostate?

1. Foley catheter insertion

2. Placement of a suprapubic catheter

3. Bladder ultrasound

4. Urethrography

The correct answer is: Foley catheter insertion

In the context of a high riding prostate, the most contraindicated intervention is Foley catheter insertion. A high riding prostate often indicates potential complications such as trauma or obstruction, often related to pelvic injuries or other urologic concerns. In such cases, attempting to insert a Foley catheter can pose risks, including further damaging the urethra or exacerbating any existing injury. Utilizing a bladder ultrasound may be safe and beneficial as it helps assess the bladder for post-void residuals or hydronephrosis without directly intervening in the urinary tract. Similarly, placement of a suprapubic catheter can be a suitable alternative for drainage while bypassing the urethra altogether, which is particularly useful if an obstructive process is suspected. Urethrography is a diagnostic tool that assesses urethral injuries and can be performed with caution in these scenarios, usually after considering the patient's condition. Therefore, Foley catheter insertion is the least appropriate intervention due to the associated risks with a high riding prostate.